Hospitals are wonderful concentrations of scientific disciplines that work together to diagnose, treat, heal, and cure a myriad of injuries and illnesses. Unfortunately, this environment can expose the personnel providing these services to some health hazards of their own. We have all heard about the infectious diseases (tuberculosis, etc.) and blood-borne pathogens (HIV, HBV, etc); but there are many more that are not patient-related.
Industrial Hygiene is the science and art engaged in the anticipation, recognition, evaluation, and control of these other workplace health hazards. In the healthcare setting these include, but are not limited to:
- Ethylene oxide
- Waste anesthetic gases
- Anti-neoplastic drugs
- Latex allergy
- and many more
Ethylene Oxide (EtO) is used within central supply as a sterilant for items that cannot be exposed to steam sterilization. Exposure usually results from improper aeration of the ethylene oxide chamber after the sterilizing process or poor gas-line connections. Most hospitals concentrate their worry about EtO to the central sterilization area. But it can also occur during off-gassing of sterilized items in outpatient surgery clinics, cardiac catheterization laboratories, operating rooms, dental labs, autopsy labs and other areas. Periodic sampling in these other areas can help identify whether your EtO programs should be broader.
Formaldehyde is used as a fixative and is commonly found in most laboratories and the morgue. Acute exposure to liquid and vapors can cause eye and respiratory irritation, while chronic exposure can cause laryngitis, bronchial pneumonia, and conjunctivitis. But most importantly, formaldehyde is a suspected carcinogen. OSHA requires employers limit exposures to 0.75 ppm as an eight-hour time weighted average. Since exposures are directly related to concentration of the solution, the duration of exposure, and the frequency of the task, all formaldehyde usage should be sampled occasionally.
Glutaraldehyde is used to disinfect heat-sensitive medical equipment in products such as Cidex, Sporicidin, and others. Glutaraldehyde is also used as a tissue fixative in histology and pathology labs and as a hardening agent in the development of x-rays. It can irritate the mucous membranes and acts as a sensitizer. This means some workers will have strong reactions even if they are exposed to only small amounts. Workers may get sudden asthma attacks with difficult breathing, wheezing, coughing, and tightness in the chest. OSHA does not regulate this chemical but the recommended limit of 0.05 ppm is a ceiling value that should not be exceeded during any part of the work shift.
This is a multi-part post that will be expanded on with additional health hazard examples in the coming weeks on our blog.
Check out an article about integrating industrial hygiene into healthcare that was published in the American Industrial Hygiene Association’s Synergist magazine.
Spotlight on ATC’s Matthew S. Parker, MS, CIH, CSP, ARM
Matthew is a Certified Industrial Hygienist, a Certified Safety Professional, and an Associate in Risk Management with over thirty years’ experience. He holds an M.S. degree in System Safety Management and a B.S. degree in Industrial Hygiene/Chemistry. Matthew was commissioned an Industrial Hygiene Officer in the U.S. Navy and progressed from a staff industrial hygienist to Safety, Health and Environmental Manager for a Ship Repair Facility. He left active duty in 1992 and became an Environmental, Safety and Health Consultant for an insurance brokerage and a DOE contractor. He was most recently the Safety, Health and Environmental Manager for a Chemical Manufacturer. He is currently a National Program Director for ATC Group Services. He retired from the Naval Reserves in 2008 as a Commander, having served as an Industrial Hygiene Officer for Surface, Air, and Marine forces. He has also served the safety profession by rising through all officer positions in the ASSE Augusta and Atlanta Chapters to Area Director for the Georgia and North Florida.